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MR. WILLIAM WISE
Optician >> Technician/Technologist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1588201420
Individual Registrant:MR. WILLIAM WISE
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
410 NORTH ST OTISVILLE, MI 48463-9705 US
Tel: 810-374-6410 Fax: --
Tel: 810-374-6410 Fax: --
Contact information for business:
410 NORTH ST OTISVILLE, MI 48463-9705 US
Tel: 810-374-6410 Fax: --
Tel: 810-374-6410 Fax: --
Registration Information:
NPI: 1588201420
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 156FX1800X | Eye and Vision Services Providers Technician/Technologist Optician |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
